Thinking about switching from RNY to VSG

I am continuing with all of my pre op testing and I am definitely going to schedule WLS in August ,but I am reconsidering the RNY and leaning more towards the VSG.  My mind started to switch because of the malabsorption and life time commitment to vitamins as well as the inability to drink as well as the re-arranging of organs.  I understand the WL may be slower with the VSG ,but I will have to be more diligent with eating properly and exercise.  I will continue my PROs and Cons list. I am not the most patient person in the world and the idea of losing the weight sooner rather than later and esing my knee pain is appealing

It's a VSG--Vertical Sleeve Gastrectomy, we are required to take vitamins for life as well and I lost 125 lbs in 8 months...not "slow" by any means. I don't know what you mean as far as not being able to "drink", whether it's alcohol or drink while eating..but we don't drink while eating either. And all surgeons, regardless of what type of surgery you have will advise against alcohol because of the empty calories and the risk of alcohol overload...

Thank you for the information...125lb in 8months is excellent.  I am referring to alcohol. I am not a weekly drinker but I am amonthly drinker.  I would dfenitley adhere to all medical guidelines so I am not worried about drinking my calories esecially in the first year.  Different procedures affect all peopl differently so some may lose more and some may lose less.

After the initial weight loss year there is no rule not to drink alcohol with the RNY or any WLS.  After the first year alcohol is fine in moderation.  Any WLS runs the risk of addiction transference.

Good luck on your decision.

Pup

Make no mistake---you're going to need to make a life-long committment to vitamins with the Sleeve, too. While the VSG doesn't cause malabsorption, it limits the amount of food you can eat, and for most people this means that you CANNOT get all the nutrients you need from food alone. (The truth is, most 'normal' people need to be taking vitamins, too---most people just plain don't eat properly and don't get in all the nutrients needed for optimal health.)

I do think the VSG is a better choice than the RNY. The VSG retains the pylorus and all normal stomach function, which I consider a big plus. And you'll still be able to take NSAIDs---since you mention knee pain, I imagine NSAIDs are your friends. (*grin*)

I do encourage you to also consider the full DS, given your BMI. The DS has the very best long-term, maintained weight-loss stats for patients of any size, but especially so for those of us with a BMI greater than 50. The DS is the VSG plus an intestinal bypass that causes a dramatic, permanent change in the way the body metabolises food.

I lost 144 lbs in 11 months including the pre-op diet, 172 lbs in 15 months. Not actually very slow. My surgeon's stats show weight loss with the sleeve averaging within a tiny percentage of as fast as the RNY.

There are lots of reasons why I love my sleeve, the most of which is keeping the normal plumbing (more particularly keeping the pyloric valve instead of a surgeon-made stoma, rather than anything to do with malabsorption). However I do take supplements every day.

One big question - which will lead to the long term results of either decision:

In your past - has eating less worked successfully with your dieting efforts?  The VSG will help you eat less - nothing more.  If you lose fine when you diet, then it will be just the ticket for you with ongoing diet stamina.  Now, if you yeild little to no results with dieting, then you may need the metabolic boost that the RNY and DS have.  Its more extreme, but so are the results.

What Valerie G. said!  Def!  Long term results are not in favour of sleeve or band.  Its not that they can't work, its that the long term results show they don't, for most people.  As wth most things in life, the RNY requires large commitment but delivers results.  

RNY is a good surgery and so is VSG. The question is about the excess weight lost long term. No one knows for sure about VSG. RNY hasquite a few people *****gain half or all of the weight back about 5-10 years down the road, and it is looking like VSG does have some weight regain between 3 and 6 years. The only study I could find that is close to 10 years out was one done in the UK with VSG'ers who were 8-9 years out. The study said 55% kept off 50% or more excess weight. Now don't freak out, the 55% was out of a tiny sample size and only the ones who were left to respond to the study. They lost many on the study to life and who moved away or did not reply to the study at some point. So if they had actually been able to track more people or had been able to get a hold of those who began the study, the numbers may have been better (or worse). Also, we have to remember that at the beginning of this study they were making the stomach larger than they are making it now. Most surgeons are creating smaller stomachs and using techniques such as suturing and oversewing that help make the stomach smaller. We may not have results of the most technically advanced sleeves until at least 2017-2018

So now to look at excess weight loss when compared to the sleeve. Many studies show that the RNY and VSG have about the same or close to the same excess weight loss at the 2 year mark. At the one year mark, RNY has a bit of a higher excess weight loss advantage. The rate of regain seems to be about the same with RNY at the sleeve BUT no one knows for sure because of lack of long term data on regain after the sleeve. We can look at posts on Obesity Help and there ARE some people who are not losing as much as they would like post VSG and are opting to get a revisional surgery. Some are also regaining weight. There are also RNY folks who are regaining weight and there are a lot of them. I think the only reason there are a lot more RNY folks reporting weight regain is because RNY is done way more often than VSG and has been done a lot longer.

RNY calorie malabsorption only lasts a few years, then you are left with the vitamin/mineral malabsorption for life. That doesn't seem like a fair trade off to me, but to each their own. I do feel that the DS is superior for long-term weight loss because the calorie malabsorption lasts forever. However, the DS is not done by many surgeons because it requires a great deal of skill and many surgeons just don't have it. The DS also requires the MOST diligence when going to the doctor and taking supplements. Vitamins and medicines after DS can cost you hundreds of dollars a month, potentially. You have to weigh that in. There are pros and cons. I have a friend who had DS and lost her insurance and her job and could not afford her medicines. She got VERY sick and had to find a charity organization to help her. I still think the DS is great, but you have to be willing to deal with the disadvantages as well.

I would personally choose VSG over RNY and I did. However, if my BMI would have been over 50 especially, I would have considered DS because of calorie malabsorption being permanent. However, the costs associated with the vitamins and medicines would have been astronomical to someone without health insurace. I can afford VSG supplements easily. My BMI was also considered low but I had some major health issues so I got surgery.

Best wishes!

 I had a high BMI of 54 (due to my height) I am 4"11 and my surgery weight was 271 I lost 100 pounds it took one year and I am still trying to lose more due to my height I have to be really thin in order to  be "normal". How tall are you? and consider all of those factors when making your decision. What ever you decide good luck and post here often its great advice on here.